Claim Associate I

Ccmsi • Danville, IL

221d • $16 - $18

About The Position

The Claim Associate I (P&C) position is based in Danville, IL, and is a full-time, in-office role with a schedule from Monday to Friday, 8:00 AM to 4:30 PM, totaling 37.5 hours per week. The compensation for this role ranges from $16 to $18 per hour, reflecting CCMSI's good-faith estimate of the base pay range in accordance with applicable pay transparency laws. Actual compensation will depend on qualifications, experience, and internal equity. Additional compensation may include bonuses, benefits, or other forms of pay. A full summary of benefits—including Medical, Dental, Vision, Life Insurance, ESOP, and 401K—is available upon request. CCMSI is an Affirmative Action / Equal Employment Opportunity employer, and background checks are conducted in compliance with applicable laws. As a leading Third Party Administrator in self-insurance services, CCMSI focuses on delivering exceptional service to clients and developing staff through structured career development programs. The company has been certified as a Great Place To Work, with employee satisfaction and retention ranking in the 95th percentile.

Requirements

• Excellent oral and written communication skills.
• Self-starter with strong organizational abilities.
• Ability to coordinate and prioritize tasks.
• Ability to operate general office equipment and perform clerical duties.
• Flexibility, initiative, and the ability to work with a minimum of direct supervision.
• Discretion and confidentiality required.
• Ability to work as a team member in a rapidly changing environment.
• Reliable, predictable attendance within client service hours.
• Responsive to internal and external client needs.

Nice To Haves

• Associate's degree or two years related business experience.
• Knowledge of medical terminology preferred.
• Proficient with Microsoft Office programs.

Responsibilities

• Set up designated claim files and complete all set up instructions, as requested.
• Learn multi line coverages, check claim for correct coverage type, assign out files to adjusters when supervisor is out, if applicable.
• Set up independent medical exams as deemed necessary under direct supervision.
• Request and monitor medical treatment of designated claims in accordance with corporate claim standards.
• Review and approve related medical, legal, damage estimates and miscellaneous invoices on designated claims.
• Assist adjuster with recorded statements.
• Negotiate any disputed bills/invoices for resolution under direct supervision.
• Make referrals to outside vendors on designated cases under direct supervision.
• Coordinate communication with clients, claimants and other appropriate parties throughout the claim adjustment process.
• Authorize and make payments on claims utilizing a claim payment program in accordance with industry standards and within established authority levels under direct supervision.
• Summarize all correspondence and medical records in claim log notes and file same in the appropriate claim.
• Compute disability rates in accordance with state laws under direct supervision, when appropriate.
• Handle management of Navex and member/client complaints, if applicable.
• Assist in running and updating reports as needed.
• Return provider calls.
• Review and maintain personal diary on claim system.
• Provide technical and clerical claims support to designated clients and claim staff, as requested.
• Process voids, refunds and recoveries.
• Act as backup for adjuster or supervisor when out of the office.
• Ensure client satisfaction and compliance with corporate claim standards and special client handling instructions.
• Handle claim overflow as needed.
• Perform other duties as assigned.

Benefits

• 4 weeks paid time off in your first year.
• 10 paid holidays.
• Medical, Dental, Vision, Life Insurance.
• Critical Illness, Short and Long Term Disability.
• 401K and ESOP.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Insurance Carriers and Related Activities
• Education Level: Associate degree